Diabetes and Insomnia

By Rosemary Black
Reviewed by QualityHealth's Medical Advisory Board

If sleep eludes you night after night, chances are you're feeling the mind-numbing effects by day. Maybe you're drinking more coffee to keep awake, or succumbing to a mid-afternoon nap just to stay alert for the rest of your day. For those who have diabetes, better control of the blood sugar may be just what you need in order to get high quality slumber every night.

It's very common for people with diabetes to have sleeping difficulties related to fluctuating blood sugar levels, says Rory Breidbart, MD, chief of endocrinology at St. Francis Hospital in Roslyn, New York.

"If the blood sugar is high, they wake up because they have to go to the bathroom," he explains. "If the blood sugar is very low, it triggers a response in the body that causes them to wake up. So blood sugar swings, being consistently high or low, can make a person feel like their sleep has not been restful."

"If the sugar is dropping, then this can wake the person up," says Harmeet Narula, MD, an endocrinologist at Stonybrook University Hospital in New York. "They may not even feel as if they are low, but may be drenched in sweat or realize they'd had nightmares while asleep."

Sleep apnea also is related to insomnia, says Narula. "If the person starts and stops breathing, that can be very concerning," he explains. "Sleep apnea is more common in folks who are chubby or obese."

Ensure a Better Night's Sleep

● If you suspect sleep apnea (and sometimes it may be your spouse or significant other who detects the symptoms since you share a bed), you may need a sleep study. One symptom of sleep apnea is excessive daytime tiredness, Narula says.

● Monitor your blood sugar levels by frequent testing. "Talk to your doctor, who may even want you to check your sugar at 2am a couple of times," Narula says. "And definitely check it right before you go to sleep. Depending on what it is, you may need a snack before you go to sleep."

● Ask your health care provider to rethink your insulin dose, says Breidbart. "You may need to give less or give more insulin at night," he says. "Or you may need to change the type of insulin you are on so that its effect will either peak or not peak at night."

● Exercise, recommends Breidbart. "It helps with sleep," he says. "All people who have diabetes should be exercising. Whether or not you need a snack depends on how intense it is." If you are playing a lot of tennis or basketball over a long period of time, you will probably need to eat. If you're just going to the gym for half an hour, usually testing before and after exercise is enough.

● If you're depressed, talk to someone close to you about your feelings. You may get help from the proper medications and from some professional counseling. And once you're feeling better about life in general, you'll sleep much more soundly at night.

Updated: February 5, 2010
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